Article by Dr Raghuram Y.S. MD (Ay) & Dr Manasa S, B.A.M.S

Neurodermatitis

Neurodermatitis is a pores and skin drawback wherein the particular person affected by the situation retains scratching his or her pores and skin on a regular basis i.e. there may be extreme urge to itch.

The lesions / patches of neurodermatitis seem dry, thick, scaly, leathery, pink, brown, yellow, gray or purple in color and scarring with development of lesion. Although precise causes aren’t recognized, irritants like tight clothes or insect bites, scratching can act like triggers. It additionally coexists with dry pores and skin, atopic dermatitis or psoriasis.

Signs embody pruritic and desquamate pores and skin lesions, erosions, hyperkeratosis and induration, altered pigmentation, erythematous plaques, lichensification and hyperpigmentation.

On this article we are going to attempt to perceive neurodermatitis from an Ayurveda perspective.

Associated Studying – Neurodermatitis

Neurodermatitis: Ayurveda Understanding

There is no such thing as a one specific situation defined in Ayurveda texts which will be precisely correlated with neurodermatitis. Right here we are going to attempt to perceive sure circumstances defined within the context of Kushta – pores and skin issues in correlation with neurodermatitis. We can even perceive neurodermatitis by trying on the situation and its signs from a dosha perspective. We are able to additionally see that neurodermatitis can be not a single situation, it may be related to many pores and skin illnesses.

Kandu – Neurodermatitis is marked by ‘itching of the pores and skin’ and might occur in lots of areas of the physique. The primary symptom of neurodermatitis is ‘repeated itching’. The affected person approaches the doctor to get ‘treatment for itching’. Subsequently, neurodermatitis will be merely thought-about as ‘Kandu’ (Ayurvedic identify for itching) and likewise handled on the traces of ‘kandu chikitsa’ with out falling into complexities of diagnosing the given situation. There are numerous circumstances whereby kandu is a predominant symptom. When common administration of kandu together with medicines, therapies and weight-reduction plan are administered, itching in all these circumstances can be relieved. So, on this situation, we’re treating the ‘chief grievance or symptom’ of the illness, kandu on this context, immaterial of the illness wherein it manifests. That is precisely why the affected person has approached the doctor.

Vata hyperlink & Vataja Kushta – Neurodermatitis is claimed to be related to dry pores and skin, atopic dermatitis or psoriasis. In all these circumstances, dryness is widespread. Dryness is attributable to vata vitiation or pores and skin vitiated by aggravated vata. So, Vataja Kushta – pores and skin issues attributable to aggravated vata could cause a situation resembling neuro-dermatitis. All kinds of kushta having vata predominance might have most signs like these of neurodermatitis. We are able to see that stress and nervousness may also provoke itching signs. Stress and nervousness may also worsen vata.

The subtypes of kushtas whereby there may be vata predominance current with medical image of neurodermatitis. They’re as beneath talked about –

–        Eka Kushta
–        Charma / Charmakhya Kushta / Hasti Charma Kushta
–        Kitibha Kushta
–        Vaipadika Kushta
–        Vicharchika Kushta
–        Mandala Kushta

Eka Kushta – Dry, thick, scaly and leathery pores and skin is a marking function of neurodermatitis. We are able to see this sample in eka kushta which is a kshudra kushta – minor pores and skin illness. It’s marked with giant patches and resembles the pores and skin of a fish and there may be absence of sweating. Since there isn’t any sweating, the pores and skin will get dry and kleda – pointless fluid is held again within the physique. This situation can be attributable to mixed aggravation of vata and kapha, whereby right here vata dries up the kapha and therefore there may be itching additionally, although not specified amongst the signs of eka kushta.

Charma / Charmakhya / Hasti Charma

The pores and skin will get thicker together with change of color in itchy spots of neurodermatitis. Such a situation is present in Hasti Charma, a sort of Kshudra Kushta – minor pores and skin illnesses. The superior stage or manifestation of neurodermatitis will be thought-about as hasti charma. Hasti charma is one among the many eleven kinds of kshudra kushta – minor pores and skin illnesses. The patches are thick and devoid of layers. This situation can be attributable to joint vitiation of vata and kapha.

Kitibha Kushta – That is additionally a sort of kshudra kushta which presents with black and brown lesions / patches which might really feel like a wound scar on contact – kina khara Sparsha. The patches are dry and laborious, as defined in neurodermatitis. This situation is commonly correlated with psoriasis, with which neurodermatitis is commonly related. This situation can be attributable to mixed aggravation of vata and kapha.

Vaipadika Kushta – That is yet one more vata-kapha sort of pores and skin dysfunction belonging to the kshudra kushta class. On this situation there are painful cracks in palms and soles. Neurodermatitis isn’t restricted to palms and soles, however it could happen in these areas too. Steady scratching on already current cracks and fissures on the pores and skin of toes and fingers can result in patches resembling neurodermatitis.

Vicharchika Kushta – It’s a kshudra kushta precipitated attributable to predominant aggravation of kapha. It presents with a number of itchy boils or eruptions / blisters of blackish brown color together with extreme itching sensation and oozing (exudation). Extreme itching and discoloration as present in vicharchika can be present in neurodermatitis. 

Mandala Kushta – It’s a Maha Kushta – larger pores and skin illness attributable to predominant aggravation of kapha which resembles neurodermatitis in its presentation. The patches or lesions on this situation are within the type of round raised patch / patches that are white or pink in color, stiff, unmovable, elevated, round and mingled with each other. The affected person experiences heaviness across the affected patch. It’s mentioned that the older patches of neurodermatitis exhibit whitening or paleness surrounded by darker hues, which resembles a medical image of mandala kushta.

Relying on the totally different colors which can be manifested within the patches of neurodermatitis, many different kinds of kushta – pores and skin illnesses presenting with these varied colors and kshudra rogas – minor illnesses which additionally current with these colors and different signs of neurodermatitis will be thought-about within the comparability and correlation.

Can predominant aggravation of kapha trigger neurodermatitis?

Itching based on Ayurveda, by default, is related to kapha. Kapha is the primary dosha liable for all types of itching. Pathological improve of kapha would trigger itching. Kapha is unctuous and liquid in nature. So, when kapha abnormally builds up within the physique undoubtedly there can be itching, however the pores and skin can even seem unctuous and there could also be exudates. However these aren’t the options of neurodermatitis. However, vata-kapha involvement could cause circumstances just like neurodermatitis. This will occur solely when the dryness of vata within the vata-kapha dysfunction turns into dominant over the wetness and unctuousness of kapha and dries it up.

Based mostly on the looks of ‘neuro dermatitis’ lesion

By look, neurodermatitis is significantly giant in dimension. It’s also dry, thick, scaly and leathery. These options are present in eka kushta and kitibha kinds of kushta, each of them fall into the class of kshudra kushta i.e. minor pores and skin illnesses. 

Based mostly on the signs of neurodermatitis

Sl No	Symptom of Neurodermatitis	Dosha involvement
1	Pruritic pores and skin lesions	Vata, Kapha or Vata-Kapha
2	Desquamative pores and skin lesions	Vata
3	Erosions with hemorrhagic tendencies	Vata, Vata-rakta
4	Hyperkeratotic pores and skin	Vata
5	Induration of dermis	Vata, Vata-Kapha
6	Altered pigmentation / hyperpigmentation	Vata, Pitta
7	Atrophic adjustments	Vata
8	Erythematous plaques	Vata, Vata-Kapha
9	Excoriation	Vata
10	Nocturnal itching	Vata
11	Pores and skin ache	Vata

Right here we are able to see that vata is predominant in virtually all doshas. Pittingn it the opposite method, vata aggravation causes the predominant signs of neurodermatitis.

Ayurveda Therapy of Neurodermatitis  

Nidana Parivarjana

Holding away from the causative components and triggers of the illness is the important thing technique to keep away from the illness, its development or recurrence. Amongst these, vata or kapha aggravating components and all etiological components enlisted as causal of kushta ought to be saved away.

Dosha Pratyanika Chikitsa

Dosha aggravation and dosha predominance in neurodermatitis ought to be analysed correctly and addressed accordingly.

Vyadhi Pratyanika Chikitsa

Addressing the basis reason for the illness ought to be the primary strategy in coping with neurodermatitis and that root trigger is likely to be a illness presenting with signs just like neurodermatitis i.e. the kinds of kushta which have been talked about above. Every other illness presenting with a pores and skin situation which seems nearer to neurodermatitis ought to be handled. When the primary illness is handled comprehensively, the illness which has branched out from it, neurodermatitis on this case, can even be addressed. Principally, kushta chikitsa i.e. therapy line of kushta ought to be adopted by way of implementing panchakarma measures, medicines, way of life adjustments and weight-reduction plan which might handle the illness from its roots.

Panchakarma measures

Virechana is the perfect treatment in instances of neurodermatitis. The Sneha – unctuous substances given earlier than administration of virechana as part of preparatory process, ought to be chosen from the context of kushta chikitsa. If solely virechana is to be given as a daily / every day detox, the drugs ought to be in an oil or ghee kind, ready with medicines / herbs that are cures for kushta and are antagonistic to the causal dosha / doshas.

Exterior therapies

Since vata is predominant dosha inflicting neurodermatitis and signs therein, it is extremely necessary to maintain the pores and skin unctuous and never enable it to dry. For this, oil therapies ought to be executed steadily. Taila Dhara – showering of natural oils and likewise utility of medicated oils on the half / components of the pores and skin in neurodermatitis are very best interventions. Udwarthana with natural powders combined in oils shall be used as and when wanted as scrubs to take away lifeless tissues and pores and skin particles.

Milk ready with Nalpamaradi Kashayam ought to be used for showering over the neurodermatitis patches.

Efficient formulations

Beneath talked about are among the necessary and efficient formulations within the therapy of neurodermatitis –

–        Tiktaka Kashayam / Ghrta
–        Mahatiktaka Kashayam / Ghrta
–        Guggulutiktaka Kashayam / Ghrta
–        Aragwadhadi Kashayam / Ghrta
–        Gandharvahastadi Kashayam
–        Gandharvahastadi Eranda Tailam
–        Nimbamritadi Eranda Tailam
–        Ksheerabala Tailam / Ksheerabala Tailam 101
–        Trivrit Leham
–        Madhusnuhi Rasayanam
–        Nalpamaradi Tailam – exterior
–        Shatadhauta Ghrtam – exterior